Struggling with a 'difficult to sedate patient' during a therapeutic endoscopic intervention, such as for massive gastrointestinal bleeding or removal of a foreign body, detracts from the quality of the intervention and potentially places the patient at increased risk. General anesthesia or propofol are options for sedation in such patients. However, these typically require the presence of an anesthesiologist, which can sometimes be a challenge to coordinate and significantly increases the total procedure costs. Thus, a safe sedation alternative would obviously be welcomed. The stated aim of the study by Cohen et al was to determine whether adding droperidol to standard benzodiazepine and narcotic regimens improves the quality of conscious sedation for prolonged or therapeutic endoscopy procedures in patients who are anticipated to be difficult to sedate.